Slowly expanding lesions are a marker of progressive MS – Commentary

Enzinger, Christian

doi:10.1177/13524585211040225

Cited by 2 publications

(5 citation statements)

References 14 publications

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“…This reconfirms histological studies (Absinta et al, 2016; Maggi et al, 2021) that reported more damage inside iron rim lesions and the role of tNAA as a biomarker for tissue damage (Lipka et al, 2023), explaining the worse clinical outcome (Absinta et al, 2019) in patients with distinct rim-shaped iron-accumulating lesions. Nevertheless, we did not find any difference between non-iron and rim lesions with regard to mIns (Lipka et al, 2023), which would have confirmed the importance of iron rims in the ongoing debate on slowly expanding lesions (Absinta & Dal-Bianco, 2021; Arnold et al, 2021; Enzinger, 2021).…”

Section: Discussionsupporting

confidence: 68%

“…Nevertheless, we did not find any difference between non-iron and rim lesions with regard to mIns (Lipka et al, 2023), which would have confirmed the importance of iron rims in the ongoing debate on slowly expanding lesions (Absinta & Dal-Bianco, 2021;Arnold et al, 2021;Enzinger, 2021).…”

Section: Discussionsupporting

confidence: 66%

“…Iron-containing lesions have mostly been studied regardless of their iron deposition subtype (Dal-Bianco et al, 2017, 2021) and their characteristic slow expansion is currently controversially discussed (Absinta & Dal-Bianco, 2021; Arnold et al, 2021; Enzinger, 2021). 7T MRI can, due to its higher spatial resolution, differentiate between iron-containing lesions with a distinct paramagnetic rim (herein “rim”) and those with a diffuse iron accumulation that involves the whole lesion(herein “area”) (Hametner et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Metabolic Insights into Iron Deposition in Relapsing-Remitting Multiple Sclerosis via 7T Magnetic Resonance Spectroscopic Imaging

Lipka

Bogner

Dal‐Bianco

et al. 2023

Preprint

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Objective To investigate the metabolic pattern of different types of iron accumulation in multiple sclerosis(MS) lesions, and compare metabolic alterations within and at the periphery of lesions and newly emerging lesions in vivo according to iron deposition. Methods 7T MR spectroscopic imaging and susceptibility-weighted-imaging was performed in 31 RRMS patients(16female/15male;mean age,36.9+-10.3years). Mean metabolic ratio were calculated for regions of interest(ROI) of normal appearing white matter(NAWM), 'non-iron', and three distinct types of iron-laden lesions, and for lesion layers of 'non-iron' and 'rim' lesions. Furthermore, newly emerging 'non-iron' and 'iron' lesions were compared longitudinally. Results 52% of iron-containing lesions showed no distinct paramagnetic rim. Of these, 'area' lesions exhibited a 65% higher mIns/tNAA(p=0.035) than 'rim' lesions. Comparing lesion layers of both 'non-iron' and 'rim' lesions, a steeper metabolic gradient of mIns/tNAA('non-iron'+15%,'iron'+40%) and tNAA/tCr('non-iron'-15%,'iron'-35%) was found in 'iron' lesions, with the lesion core showing +22% higher mIns/tNAA(p=0.005) and -23% lower tNAA/tCr(p=0.048) in 'iron' compared to 'non-iron' lesions. In newly emerging lesions, 46% showed iron accumulation, with the drop in tNAA/tCr after lesion formation remaining significantly lower compared to pre-lesional tissue over time in 'iron' lesions(year0:p=0.013,year1:p=0.041) as opposed to 'non-iron' lesions(year0:p=0.022,year1:p=0.231). Conclusion 7T MRSI allows in vivo characterization of different iron accumulation types showing metabolic differences. Furthermore, the larger extent of neuronal damage in lesions with a distinct iron rim was reconfirmed, but with metabolic differences in lesion development between (non)-iron-containing lesions. This highlights the ability of MRSI to further investigate different types of iron accumulation and suggests possible implications for disease monitoring. Clinical relevance statement: The clinical importance of differentiating various types of iron accumulation in MS lesions was shown, as contrasting metabolic profiles are likely associated with different levels of tissue damage.

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Section: Discussionsupporting

confidence: 68%

Section: Discussionsupporting

confidence: 66%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Metabolic Insights into Iron Deposition in Relapsing-Remitting Multiple Sclerosis via 7T Magnetic Resonance Spectroscopic Imaging

Lipka

Bogner

Dal‐Bianco

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…This reconfirms histological studies ( Absinta et al, 2016 , Maggi et al, 2021 ) that reported more damage inside iron rim lesions and the role of tNAA as a biomarker for tissue damage ( Lipka et al, 2023 ), explaining the worse clinical outcome ( Absinta et al, 2019 ) in patients with distinct rim-shaped iron-accumulating lesions. Nevertheless, we did not find any difference between non-iron and rim lesions with regard to mIns ( Lipka et al, 2023 ), which would have confirmed the importance of iron rims in the ongoing debate on slowly expanding lesions ( Absinta and Dal-Bianco, 2021 , Arnold et al, 2021 , Enzinger, 2021 ).…”

Section: Discussionsupporting

confidence: 67%

“…Iron-containing lesions have mostly been studied regardless of their iron deposition subtype ( Dal-Bianco et al, 2017 , 2021) and their characteristic slow expansion is currently controversially discussed ( Absinta and Dal-Bianco, 2021 , Arnold et al, 2021 , Enzinger, 2021 ). 7 T MRI allows for higher spatial resolution and can differentiate between iron-containing lesions with a distinct paramagnetic rim (herein “rim”) and those with a diffuse iron accumulation that involves the whole lesion (herein “area”) ( Hametner et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%